We prioritize botox for the rich over cancer treatments for the poor. This is the status quo that we have that is so incredibly expensive. The debate over health care should be focusing on two questions:

How much of our national wealth are we going to choose to spend on health care?

How do we want to allocate our limited health care technology and services?

We can agree to spend a lot of our national wealth on health care. After all, we need to spend it on something. The rate of growth is too much now – but we don’t need to reduce our levels of health care spending to that of Great Britain. (They spend 41 cents on the dollar that we spend for better overall results as measured by life expectancy, infant mortality, as well as overall patient satisfaction.)

Then – to the second question – how do we allocate access? Right now, we provide emergency treatment to everyone; those with the most money get any treatment they like without significant waits; the rest of us wait, but at least are treated if we have insurance coverage. There’s a reason why rich people from around the world travel to America – and it’s not just because we have great doctors. It’s because they get to cut the line and get treated ahead of those with less financial status because our system rations by money.

For the rest of us, the health care reforms being discussed now won’t reverse this privileged position for the rich. What Obama is proposing is not anything so radical. But rather he seeks to accomplish several things, to moderately improve our current system:

it will eliminate the fear that your insurance company will drop your coverage once you get sick – putting you on the fast road to being poor and at the bottom rung of our society and in our health care system at the same time;

it will – through incentives, tax breaks, and mandates – ensure that everyone has a base level of coverage;

for the many who already do have coverage, it will provide a sense of security – a peace of mind – that even if you lose your job, you will still be able to get affordable health insurance; and

This moderate plan bears little resemblance to the “government takeover of health care” that critics are directing their fire at. It isn’t about “rationing.” In fact, what it seeks to do is address the rationing our system already does. In this way, the attacks on the plan are Rovian in the most diabolical sense – they take the strength of the plan, and try to turn it into a weakness.